Provider Demographics
NPI:1912247495
Name:STANDARD, DELPHINE ANN (CERTIFIED-LICENSED M)
Entity Type:Individual
Prefix:
First Name:DELPHINE
Middle Name:ANN
Last Name:STANDARD
Suffix:
Gender:F
Credentials:CERTIFIED-LICENSED M
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6099 S. QUEBEC ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80237
Mailing Address - Country:US
Mailing Address - Phone:303-221-5222
Mailing Address - Fax:
Practice Address - Street 1:6099 S. QUEBEC ST
Practice Address - Street 2:SUITE 100
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80111
Practice Address - Country:US
Practice Address - Phone:303-221-5222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-21
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2667225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist